Samuel Klein Roth, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

101361 Issued in NC

Practice address

105 SW Cary Pkwy
Suite 300
Cary, NC 27511-5600

Phone

(919) 467-3203

Fax

(919) 459-5401

NPI assigned

Jun 8, 2006

Last updated

Oct 13, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Carolinas Medical Center

  dba Atrium Health Levine Children's Gastroenterology

  • Obstetrics & Gynecology Physician
  • Charlotte, NC
  • NPI 1275774333
  Medicare reassignment
• The Charlotte-Mecklenburg Hospital Authority

  dba Levine Cancer Institute

  • Medical Oncology Physician
  • Indian Land, SC
  • NPI 1669738829

  NC

  Medicare reassignment
• Carolinas Medical Center

  dba Atrium Health Pharmacy Kenilworth

  • Community/Retail Pharmacy
  • Charlotte, NC
  • NPI 1982710554
  NPD
• The Charlotte-Mecklenburg Hospital Authority

  dba Atrium Health Addiction Services Ballantyne

  • Addiction (Substance Use Disorder) Counselor
  • Charlotte, NC
  • NPI 1124593470
  NPD
• The Charlotte-Mecklenburg Hospital Authority

  dba Atrium Health Pineville Rehabilitation Hospital

  • Rehabilitation Hospital Unit
  • Charlotte, NC
  • NPI 1962987131
  NPD
• Carolina Specialty Oncology, PA

  • Urology Physician
  • Raleigh, NC
  • NPI 1477520088
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286928000000",
    "number": "1700827268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 SW CARY PKWY",
            "address_2": "SUITE 300",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275115600",
            "telephone_number": "919-467-3203",
            "fax_number": "919-459-5401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 SW CARY PKWY",
            "address_2": "SUITE 300",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275115600",
            "telephone_number": "919-467-3203",
            "fax_number": "919-459-5401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "SAMUEL",
        "middle_name": "KLEIN",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2010-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "101361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexus Ross
• Kymmalett Anntyonette Ross, PHD
• Marissa Kerowyn Ross, PHARMD
• Dayna Rossi, NP
• Elizabeth Roth
• Nicholas Robert Rothrock
• Zachary Rothwell, PMHNP
• Diana Grace Rotsko, MS, RD, LDN
• Courtnee A R Roulhac, M.ED., CCC-SLP
• Round the Clock Home Health Services LLC

• Medical Physician Assistant in Cary, NC
• Providers in Cary, NC by specialty
• Medical Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.